Individual provider Active NPI

Brooke Freeman Pettitt, PHARMD

  • Pharmacist
  • Charlotte, NC
National Provider Identifier
1235620436
Registry record updated May 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
27620 Issued in NC
Practice address
7828 Pineville Matthews Rd
Charlotte, NC 28226-3910
Phone
(704) 341-2019
NPI assigned
May 23, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 27620 NC Primary

Addresses

Primary practice location

7828 Pineville Matthews Rd
Charlotte, NC 28226-3910

Mailing address

400 S Jennings Ave Apt 144
Fort Worth, TX 76104-2334
Phone (803) 899-9543

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
27620NCMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Walgreen Co Past Accepting new patients
Walgreen Co PastSince Apr 24, 2022 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1527033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527033600000",
    "number": "1235620436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 S JENNINGS AVE APT 144",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761042334",
            "telephone_number": "803-899-9543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7828 PINEVILLE MATTHEWS RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282263910",
            "telephone_number": "704-341-2019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTITT",
        "first_name": "BROOKE",
        "middle_name": "FREEMAN",
        "name_prefix": "Mrs.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-23",
        "last_updated": "2018-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NC",
            "license": "27620",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.